Felix C, Blatt J, Goodman M A, Medina J
Med Pediatr Oncol. 1985;13(5):269-72. doi: 10.1002/mpo.2950130505.
Avascular necrosis of bone (AVNB) is a known complication of systemic adrenocorticosteroid therapy, and one which is thought to be dose-related. However, despite the large amounts of prednisone which have been used in the standard treatment of acute lymphocytic leukemia (ALL), AVNB rarely has been reported in children with that disease. We described our experience with one adolescent with ALL who developed multifocal AVNB presenting as bone pain after aggressive chemotherapy that included a high cumulative dose of corticosteroids as well as other antitumor agents, some of which also have been associated with AVNB. Four similar cases from the literature are reviewed. Because the bone pain of AVNB can mimic that of leukemic relapse, this is an important entity to be aware of, and one which may become more common with increasingly aggressive combination chemotherapy.
骨缺血性坏死（AVNB）是全身使用肾上腺皮质类固醇治疗已知的并发症，并且被认为与剂量相关。然而，尽管在急性淋巴细胞白血病（ALL）的标准治疗中使用了大量泼尼松，但该病患儿中很少有AVNB的报道。我们描述了1例患ALL的青少年的情况，该患者在接受包括高累积剂量皮质类固醇以及其他一些也与AVNB有关的抗肿瘤药物的强化化疗后，出现多灶性AVNB并表现为骨痛。本文还回顾了文献中4例类似病例。由于AVNB的骨痛可能与白血病复发的骨痛相似，因此这是一个需要了解的重要情况，并且随着联合化疗越来越强化，这种情况可能会变得更加常见。
